Levoxyl, Tirosint-Sol, Synthroid, Unithroid, Euthyrox, Tirosint, Armour Thyroid, Cytomel, Nature-Throid, NP Thyroid, NP Thyroid 120, Thyrolar, Westhroid, WP Thyroid
Levothyroxine sodium
Treats:
Hypothyroidism (the body does not produce enough thyroid hormone)
An enlarged thyroid gland
Thyroid cancer
Levoxyl is a medication used to treat an underactive thyroid gland (hypothyroidism). Levoxyl is a synthetic hormone that is chemically identical to your body’s natural thyroid hormone, thyroxine (T4). Levoxyl is a brand version of the drug levothyroxine sodium, which has been available for many years. In the treatment of underactive thyroid, Levoxyl use is common.
Tell your prescribing healthcare provider about any other prescription drugs or over-the-counter supplements that you take or conditions that you have, especially heart conditions or adrenal insufficiency.
Levoxyl should be taken by mouth in the morning on an empty stomach with a full glass of water 30 minutes to one hour before food or other medications.
Calcium carbonate and ferrous sulfate (iron) may reduce the effectiveness of Levoxyl. Take Levoxyl four hours before or after calcium-containing products or iron. If you take a multivitamin, you may have to adjust when you take it so that it does not interfere with Levoxyl.
It may take weeks before you notice that Levoxyl is working. Keep taking it, and do not abruptly stop taking it.
Levoxyl may cause symptoms of hyperthyroidism, such as irregular or increased heart rate, weight loss, sweating, and hyperactivity. Speak to your provider about any symptoms you are experiencing. The dosages may need to be adjusted a few times before finding the best daily dose for each person.
Tablet
25 mcg
50 mcg
75 mcg
88 mcg
100 mcg
112 mcg
125 mcg
137 mcg
150 mcg
175 mcg
Dosing of Levoxyl depends on a variety of factors, such as age, weight, cardiovascular status, medications taken, or other conditions present. Dosing is usually titrated until thyroid function and thyroid hormone levels, TSH and T4, return to normal.
For healthy, non-elderly adults who have only had hypothyroidism for a few months or shorter, full replacement dosing is recommended:
Starting dose: 1.6 mcg per kg per day
Adjust the daily dose by 12.5 mcg to 25 mcg every four to six weeks until thyroid hormone levels return to normal
Standard dosing is 25 mcg to 200 mcg once per day
For patients who have severe or long-standing hypothyroidism, dosing will be lower than the standard dosing:
Starting dose: 12.5 mcg to 25 mcg per day
Adjust the daily dose by 12.5 mcg to 25 mcg every two to four weeks until thyroid hormone levels return to normal
For older adult patients or those with underlying cardiac disease, dosing will also be lower than the standard dosing:
Starting dose: 12.5 mcg to 25 mcg per day
Adjust the daily dose by 12.5 mcg to 25 mcg every six to eight weeks until thyroid hormone levels return to normal
Levoxyl
100mcg tablet
Levoxyl
112mcg tablet
Levoxyl
125mcg tablet
Levoxyl
137mcg tablet
Levoxyl
150mcg tablet
Levoxyl
175mcg tablet
Levoxyl
200mcg tablet
Levoxyl
25mcg tablet
Levoxyl
50mcg tablet
Levoxyl
75mcg tablet
Levoxyl
88mcg tablet
Take your medicine as directed.
Your doctor will tell you how much to take and how often.
Your dose may need to be changed several times to find what works best for you.
You may have to take this medicine for four to eight weeks before your symptoms start to get better.
Take your medicine at the same time every day.
Take this medicine in the morning on an empty stomach, at least 30 to 60 minutes before eating breakfast.
If you are giving this medicine to a baby or child who cannot swallow the tablet whole, crush the tablet and mix it in one to two teaspoons (5 to 10 milliliters) of water. Give the mixture right away using a spoon or dropper. Do not mix the tablet with any other liquid except water. Do not store the mixture for future use.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
Do not stop taking this medicine without first checking with your doctor. You may need to take smaller and smaller doses before completely stopping the medicine.
Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
Take the missed dose as soon as possible.
Skip the missed dose if it is almost time for your next regular dose.
You should not use two doses at the same time.
Do not take Levoxyl if you have had an allergic reaction to levothyroxine or glycerol or if you have an uncorrected adrenal gland problem or cardiac condition.
You should not use this medicine if you have had an allergic reaction to any type of thyroid hormone or if you have an overactive thyroid gland.
Tell your doctor if you are pregnant or breastfeeding.
Tell your doctor if you have recently received radiation treatment with iodine.
Check with your doctor before taking this medicine if you have:
Heart or blood vessel disease
High blood pressure
Diabetes
Kidney disease
Liver disease
Anemia
Blood clotting problems
Diabetes
Osteoporosis
Pituitary gland problems
Adrenal gland problems
This medicine may cause the following problems:
Heart problems, including angina (chest pain) and heart arrhythmias
Low bone density
Large doses of thyroid hormones, especially when taken with diet pills, can result in dangerous adverse effects, such as:
Inability to tolerate heat
Extreme nervousness or irritability
Tremors
Severe diarrhea
Intense sweating
This medicine should not be used to treat obesity or as part of a treatment plan for a weight control program.
Tell any doctor or dentist who treats you that you are taking this medicine.
Make sure you see your doctor for regular check-ups so that your condition can be followed closely.
Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
Some foods and medicines can affect how levothyroxine works. Tell your doctor if you are taking any of the following:
Amiodarone
Asparaginase
Carbamazepine
Clofibrate
Dexamethasone
Digoxin
5-fluorouracil
Furosemide
Heroin
Imatinib
Ketamine
Methadone
Mitotane
Nicotinic acid
Phenobarbital
Phenytoin
Rifampin
Tamoxifen
Beta-blockers
Birth control pills (including estrogen)
Blood thinners (including heparin and warfarin)
Insulin or diabetes medicine
Antidepressants (including amitriptyline and maprotiline)
NSAIDs
Salicylates
Steroids (including dexamethasone, androgens, and anabolic steroids)
Products used for colds, asthma, appetite control, hay fever, or sinus problems
In order to lessen the impact of drug interactions with Levoxyl, take the following medications at least four hours before or four hours after you take Levoxyl:
Kayexalate
Lanthanum
Orlistat
Sevelamer
Sucralfate
Antacids (including aluminum or magnesium hydroxide and simethicone)
Medicine to lower cholesterol (including cholestyramine, colesevelam, and colestipol)
Stomach medicine (including lansoprazole, omeprazole, and pantoprazole)
Any medicine that contains calcium or iron
Cottonseed meal, dietary fiber, soybean flour (infant formula), or walnuts may decrease the absorption of this medicine. Talk with your doctor if you have questions.
Do not eat grapefruit or drink grapefruit juice while you are using this medicine.
Large doses of thyroid hormones, especially when taken with diet pills, can result in dangerous side effects.
Levoxyl has some side effects. Fortunately, most of them are able to be resolved by lowering the daily dose of Levoxyl. However, there are a few side effects that warrant a visit to a healthcare provider. Seek medical help right away if you experience an allergic reaction, trouble breathing, severe chest pain, or swelling of the face, tongue, or legs. Talk to your doctor if you experience any other side effects, especially if you notice any heart irregularities.
Serious side effects:
Seizures or tremors
Fast, pounding, or irregular heartbeat
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, or trouble breathing
Chest pain that may spread
Fainting
Confusion
Swelling of the face, tongue, or lower legs
Feeling cold
Unusual tiredness or weakness
Dizziness or lightheadedness
Stomach pain
Walking with a limp from knee or hip pain (in children)
Severe headache, blurred or double vision, nausea, or vomiting (in children)
Skin rash or hives
Shortness of breath or trouble breathing
Inability to tolerate heat
Extreme nervousness or irritability
Tremors
Severe diarrhea
Intense sweating
Less serious side effects:
Anxiety
Irregular menstrual periods
Headache
Trouble sleeping
Hair loss
Appetite or weight changes
Diarrhea
Muscle spasm or weakness
Nervousness
Sensitivity to heat
Highlights of prescribing information, Pfizer (2018)
Josephine Bawab, Pharm.D., graduated from Virginia Commonwealth University School of Pharmacy. She began working in community pharmacy in 2012 and has worked for multiple chain pharmacies since then. She is passionate about helping patients and precepting students. She currently works and resides in Virginia, where she is just a few minutes away from the beach.
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